Journal:Conversion of a classical microbiology laboratory to a total automation laboratory enhanced by the application of lean principles

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Full article title Conversion of a classical microbiology laboratory to a total automation laboratory enhanced by the application of lean principles
Journal Microbiology Spectrum
Author(s) Trigueiro, Graça; Oliveira, Carlos; Rodrigues, Alexandra; Seabra, Sofia; Pinto, Rui; Bala, Yohann; Granado, Monica G.; Vallejo, Sandra; Gonzalez, Victoria; Cardoso, Carlos
Author affiliation(s) Dr. Joaquim Chaves Clinical Analysis Laboratory, bioMérieux
Primary contact Email: alexandra dot cristina at jcs dot pt
Editors Doucet-Populaire, Florence C.
Year published 2024
Volume and issue 12(2)
Article # e02153-23
DOI 10.1128/spectrum.02153-23
ISSN 2165-0497
Distribution license Creative Commons Attribution 4.0 International
Website https://journals.asm.org/doi/10.1128/spectrum.02153-23
Download https://journals.asm.org/doi/pdf/10.1128/spectrum.02153-23?download=true (PDF)

Abstract

Laboratory automation in microbiology improves productivity and reduces sample turnaround times (TATs). However, its full potential can be unlocked through the optimization of workflows by adopting lean principles. This study aimed to explore the relative impact of laboratory automation and continuous improvement events (CIEs) on productivity and TATs. Laboratory automation took place in November 2020 and consisted of the introduction of WASPLab and VITEK MS systems. CIEs were run in May and September 2021. Before the conversion, the laboratory processed approximately 492 samples on weekdays and had 10 full-time equivalent (FTE) staff for a productivity of 49 samples/FTE/day. In March 2021, after laboratory automation, the caseload went up to approximately 621 while the FTEs decreased to 8.5, accounting for a productivity improvement to 73 samples/FTE/day. The hypothetical productivity went up to 110 samples/FTE/day following CIEs, meaning that the laboratory could at that point deal with a caseload increase to approximately 935 with unchanged FTEs. Laboratory conversion also led to an improvement in TATs for all sample types. For vaginal swabs and urine samples, median TATs decreased from 70.3 hours (interquartile range [IQR]: 63.5–93.1) and 73.7 hours (IQR: 35.6–50.7) to 48.2 hours (IQR: 44.8–67.7) and 40.0 hours (IQR: 35.6–50.7), respectively. Automation alone was responsible for 37.2% and 75.8% of TAT reduction, respectively, while the remaining reduction of 62.8% and 24.2%, respectively, was achieved due to CIEs. The laboratory reached productivity and TAT goals predefined by the management after CIEs. In conclusion, automation substantially improved productivity and TATs, while the subsequent implementation of lean management further unlocked the potential of laboratory automation.

Importance

In this study, we combined total laboratory automation with lean management to show that appropriate laboratory work organization enhanced the benefit of the automation and substantially contributed to productivity improvements. Globally, the rapid availability of accurate results in the setting of a clinical microbiology laboratory is part of patient-centered approaches to treat infections and helps the implementation of antibiotic stewardship programs backed by the World Health Organization (WHO). Locally, from the point of view of laboratory management, it is important to find ways of maximizing the benefits of the use of technology, as total laboratory automation is an expensive investment.

Keywords: turnaround time, productivity, lean principles, laboratory automation, change management

Introduction

Acknowledgements

Funding

Competing interests

Yohann Bala, Monica Gutiérrez Granado, Sandra Vallejo, and Victoria Gonzalez are employees of bioMérieux SA.

References

Notes

This presentation is faithful to the original, with only a few minor changes to presentation. In some cases important information was missing from the references, and that information was added.